Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque
Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque
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DOI：
10.1016/j.jcct.2020.11.002
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发表时间：
2021-04-01
影响因子：
5.4
通讯作者：
Narula, Jagat
中科院分区：
文献类型：
--
作者：
Shaw, Leslee J.;Blankstein, Ron;Narula, Jagat
冠状动脉计算机断层扫描血管造影（CCTA）提供了丰富的临床意义的信息，除了单独的解剖狭窄，包括存在或不存在非阻塞性动脉粥样硬化和高风险斑块的特点，作为先兆事件的冠状动脉事件。然而，关于如何识别和量化这些特征或它们在循证临床决策中的应用，还没有统一的协议。来自心血管计算机断层扫描学会和北美心血管成像学会的这份声明解决了这一差距，并对冠状动脉粥样硬化成像的现有证据进行了全面审查。在本声明中，我们提供了高危斑块（HRP）特征的标准化定义，并将风险分层有效性的证据提炼为可用的实践要点。本声明概述了如何通过确定结构化CCTA报告中包括的关键要素将此信息传达给转诊医生和患者-动脉粥样硬化斑块的存在和严重程度（描述性声明，CAD-RADS（TM）类别），节段参与评分，HRP特征（例如，低衰减斑块、正性重塑）和冠状动脉钙评分（当进行时）。CCTA上动脉粥样硬化的严格记录提供了一个重要的机会，为预防保健提出建议，并为高危患者启动和指导有效的护理策略。(C)2020由Elsevier Inc.出版。代表心血管计算机断层扫描学会。
Coronary computed tomographic angiography (CCTA) provides a wealth of clinically meaningful information beyond anatomic stenosis alone, including the presence or absence of nonobstructive atherosclerosis and high-risk plaque features as precursors for incident coronary events. There is, however, no uniform agreement on how to identify and quantify these features or their use in evidence-based clinical decision-making. This statement from the Society of Cardiovascular Computed Tomography and North American Society of Cardiovascular Imaging addresses this gap and provides a comprehensive review of the available evidence on imaging of coronary atherosclerosis. In this statement, we provide standardized definitions for high-risk plaque (HRP) features and distill the evidence on the effectiveness of risk stratification into usable practice points. This statement outlines how this information should be communicated to referring physicians and patients by identifying critical elements to include in a structured CCTA report - the presence and severity of atherosclerotic plaque (descriptive statements, CAD-RADS (TM) categories), the segment involvement score, HRP features (e.g., low attenuation plaque, positive remodeling), and the coronary artery calcium score (when performed). Rigorous documentation of atherosclerosis on CCTA provides a vital opportunity to make recommendations for preventive care and to initiate and guide an effective care strategy for at-risk patients. (C) 2020 Published by Elsevier Inc. on behalf of Society of Cardiovascular Computed Tomography.